Cycling is not associated with increased risk for impotence or urinary symptoms. The largest and best study on the subject to date shows that serious cyclists are no more likely to suffer impotence or urinary problems than swimmers or runners (The Journal of Urology, March 2018;199(3):798–804). This refutes earlier and much smaller studies that suggested increased risk for these conditions (Int J Impot Res, 2001;13:298). Other earlier studies suggesting an association were hampered by extremely small numbers of participants and control groups (Korean J Urol, May 2011;52(5):350-4). The authors of this new study used questionnaires filled out by 2,774 cyclists, 539 swimmers and 789 runners. The results showed that high-intensity cyclists (>2 years, >3 times a week, >25 miles per day) suffered even less from impotence than casual riders. The only genito-urinary symptom that cyclists suffered more frequently than swimmers or runners was narrowing in the urethra (urinary tube) to decrease the flow rate of urine from the body, and that symptom was extremely rare. The largest previous study, a cross-sectional internet survey of 5,282 cyclists, failed to show any increased risk for impotence in cyclists (J Mens Health, 2014;11:75).

Prevention of Numbness
Cyclists who stood more than 20 percent of the time during cycling and/or had their handlebars level or above their seat height reported less genital numbness or saddle sores. Every cyclist learns sooner or later to prevent numbness by using a bike that fits well, wearing shorts with padding, using a cutout seat, setting the seat level with the ground, and/or standing up frequently and whenever they start to feel numbness.

My Recommendations
This study found that neither recreational nor intense cyclists suffered increased risk for lower urinary tract symptoms. Both groups of cyclists were less likely to be impotent than non-cyclists, probably because of the protective effect of exercise on sexual potency. The cyclists were more likely to suffer transient genital numbness and saddle sores.
• Before you ride, make sure that your bike fits your body properly. Most bike shops offer fitting assistance if you have any questions. You can tell when a bike fits because you will feel comfortable when you sit and pedal on the bike, even for a long ride.
• If you are a recreational cyclist, set your seat so that it is lower than your handle bars and level with the ground.
• If your seat makes you uncomfortable, pick another one. Try seats that have some padding, have a center cut-out, and are wider than your sitz bones. You may need to try several seats before you find one you like.
• If you begin to feel discomfort when you ride, immediately stand up for at least a few pedal strokes. If that does not help, stop riding and readjust your seat.

About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities.
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